ESPE Abstracts (2016) 86 P-P2-293

Impact of Demographic Factors on Diabetic Ketoacidosis Occurrence at Type 1 Diabetes Onset in Childhood

Flora Tzifi, Ioanna Kosteria, Ioannis Anargyros Vasilakis, Evangelos Christopoulos-Timogiannakis, Diamanto Koutaki, George Chrousos & Christina Kanaka-Gantenbein


Diabetes Center, Division of Endocrinology, Diabetes and Metabolism, First Department of Pediatrics, Medical School, National and Kapodistrian University of Athens, Athens, Greece


Background: Diabetic Ketoacidosis (DKA) in newly diagnosed children with Type 1 Diabetes (T1D) has been associated in previous studies with several factors, such as age or season of diagnosis.

Objective and hypotheses: The aim of the present study was to assess the impact of age, gender, birth order and seasonality in DKA occurrence in newly diagnosed T1D pediatric patients.

Method: Data of children aged 0–14 years newly diagnosed with T1D between January 2010 and December 2015 were analyzed according to age, gender and seasonality of date of diagnosis and birth using both univariate and multivariate logistic regression analysis. DKA diagnosis and its severity were classified according to ISPAD guidelines 2014.

Results: Hundred and fifty nine newly diagnosed T1D children in the years 2010–2015 were recorded and 89 (55.9%) presented with DKA (severe DKA in 23.59%, moderate in 43.82%, and mild in 32.58%). In univariate logistic regression analysis neither age (Exp(B):0.930, 95% CI: 0.859–1.006, P=0.072) nor the season of birth exhibited any significant effect (Exp(B):1.405, 95% CI: 0.748–2.639, P=0.290) on DKA occurrence, while male sex was negatively associated with DKA at T1D diagnosis (Exp(B):0.482, 95% CI: 0.254–0.915, P=0.026). Furthermore, diagnosis during the cold months (fall-winter) was borderline negatively associated (Exp(B):0.536, 95% CI: 0.284–1.014, P=0.055) with DKA, while the order of birth (1st born children vs other) had no impact on DKA occurrence (Exp(B):1.122, 95% CI: 0.598–2.106, P=0.720). In multivariate logistic regression analysis only male gender (Exp(B):0.470, 95% CI: 0.246–0.901, P=0.023) and the diagnosis during fall-winter (Exp(B):0.521, 95% CI: 0.272–0.997, P=0.049) were statistically negatively associated with DKA occurrence at T1D diagnosis.

Conclusion: Male gender and diagnosis during the cold months are less associated with DKA at T1D onset.

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